PDF File
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Eff. Date: 08/28/2019
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ACCOLATE, ZAFIRLUKAST |
469 KB |
PDF File
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Eff. Date: 05/20/2020
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ADDERALL, AMPHETAMINE, AMPHETAMINE/DEXTROAMPHET SALTS, DESOXYN, DEXMETHYLPHENIDATE, EVEKEO, FOCALIN, METHAMPHETAMINE, METHYLIN, METHYLPHENIDATE, PROCENTRA, RITALIN, ZENZEDI, ADZENYS, ADZENYS-ODT, AMPHETAMINE/DEXTROAMPHET SALTS ER, ADHASIA XR, APTENSIO XR, CONCERTA ER, COTEMPLA, DAYTRANA, DEXEDRINE, DEXMETHYLPHENIDATE, DYANAVEL, FOCALIN XR, METHYLPHENIDATE ER, METHYLPHENIDATE CD, MYDAYIS, QUILLICHEW, QUILLIVANT, RITALIN, VYVANSE, GUANFACINE, INTUNIV, STRATTERA, CLONIDINE |
933 KB |
PDF File
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Eff. Date: 7/15/2019
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CERDELGA, CEREZYME, ELELYSO, MIGLUSTAT, VPRIV, ZAVESCA |
410 KB |
PDF File
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Eff. Date: 03/21/2019
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TEKAMLO, TEKTURNA, AMTURNIDE, TEKTURNA HCT |
1 MB |
PDF File
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Eff. Date: 12/10/2019
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ORALAIR |
350 KB |
PDF File
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Eff. Date: 3/21/2019
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AKYNZEO, ANZEMET, APREPITANT, EMEND, GRANISETRON HCL, SANCUSO |
291 KB |
PDF File
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Eff. Date: 07/30/2020
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ABILIFY, ABILIFY DISCMELT, ABILIFY MAINTENA, ABILIFY MYCITE, AMITRIPTYLINE/PERPHENAZINE, ARIPIPRAZOLE, ARISTADA ER, CAPLYTA, CHLORPROMAZINE, CLOZAPINE, CLOZAPINE ODT, CLOZARIL, FANAPT, FAZACLO, FLUPHENAZINE, GEODON, HALOPERIDOL, INVEGA ER, INVEGA SUSTENNA, INVEGA TRINZA, LATUDA, LOXAPINE, MOLINDONE HCL, OLANZAPINE, OLANZAPINE ODT, OLANZAPINE/FLUOXETINE, ORAP, PALIPERIDONE ER, PERPHENAZINE, PERSERIS ER, PIMOZIDE, QUETIAPINE , REXULTI, RISPERDAL , RISPERDAL CONSTA, RISPERDAL M-TAB, RISPERIDONE, SAPHRIS, SECUADO, SEROQUEL, SYMBYAX, THIORIDAZINE, THIOTHIXENE, TRIFLUOPERAZINE, VERSACLOZ, VRAYLAR, ZIPRASIDONE, ZYPREXA, ZYPREXA RELPREVV, ZYPREXA ZYDIS |
567 KB |
PDF File
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Eff. Date: 2/18/2020
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ALPRAZOLAM, XANAX, CHLORDIAZEPOXIDE, MEPROBAMATE, OXAZEPAM, DIAZEPAM, CLONAZEPAM, KLONOPIN, CLORAZEPATE, TRANXENE T, LORAZEPAM, TEMAZEPAM, TRIAZOLAM, ZOLPIDEM, ESTAZOLAM, RESTORIL, TEMAZEPAM, ESZOPICLONE, LUNESTA, SONATA, ZALEPLON, INTERMEZZO, ZOLPIDEM, AMBIEN, EDLUAR, BELSOMRA, BUTISOL SODIUM, FLURAZEPAM, HETLIOZ, ROZEREM |
740 KB |
PDF File
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Eff. Date: 4/26/2019
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ARIKAYCE |
218 KB |
PDF File
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Eff. Date: 03/22/2019
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BUNAVAIL, BUPRENORPHINE, BUPRENORPHINE-NALOXON, SUBOXONE, ZUBSOLV |
809 KB |
PDF File
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Eff. Date: 05/23/2019
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CARISOPRODOL-ASPIRIN, CARISOPRODOL COMPOUND, CARISOPRODOL CPD-CODEINE, CARISOPRODOL, SOMA |
260 KB |
PDF File
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Eff. Date 10/28/2020
|
NURTEC ODT, UBRELVY |
934 KB |
PDF File
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Eff. Date 08/29/2019
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AIMOVIG, AJOVY, EMGALITY |
314 KB |
PDF File
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Eff. Date: 10/29/2019
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ARMODAFINIL, MODAFINIL, NUVIGIL, PROVIGIL, SUNOSI |
406 KB |
PDF File
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Eff. Date: 10/22/2012
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|
22 KB |
PDF File
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Eff. Date: 12/09/2016
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|
18 KB |
PDF File
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Eff. Date: 03/10/2020
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ALA-HIST, ALLFEN DM TAB, AP-HIST DM LIQ, APRODINE TAB, BENZONATATE, BROMFED DM CGH SYR, BROMPHENIR-PSEUDO-DM SYR, BROTAPP, CHEST CONG RELIEF, CHLD DELSYM, CHLD COLD & CGH DM ELIXI, CHLD MUCINEX, CHLD DAYCLEAR ALL CGH, CHLO TUSS LIQ, CGH DM, CGH SYR, DALLERGY, DECONEX DMX TAB, DECONEX IR TAB, DELSYM, DEXTROMETHORPHAN ER, DIMAPHEN, ED A-HIST, ED BRON GP LIQ, ED CHLORPED D PEDIATRIC DROPS, ENDACOF-DM LIQ, EX ACTION CGH SYR, GUAIFEN, GUAIFEN ER, GUAIFEN/PSE, HISTEX, IOPHEN, KIDKARE CGH & COLD LIQ, KID'S MUCINEX MINI-MELTS PACK, LODRANE D CAPSULE, LOHIST, LORTUSS, MAXIPHEN, M-END DMX LIQ, M-HIST DM LIQ, MUCINEX, MUCUS RELIEF, NASAL DECON SPRAY, NASOPEN PE LIQ, NINJACOF LIQ, NOHIST, NOSE DROPS, ORGAN-I, PEDIATRIC CGH-COLD LIQ, PHENYLEPHRINE-PYRILAMINE, POLY HIST, POLY-VENT, POLYTUSSIN, PROMETHAZINE, Q-TUSS, RESCON, RESPAIRE-30, ROBAFEN, RU-HIST D, RYMED, SILTUSS, SM NASAL SPRAY, SM TUSS DM, STAHIST AD, SUDOGEST SINUS & ALLERGY TAB, TUSS, VANACOF, VANATAB |
438 KB |
PDF File
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Eff. Date: 4/24/2020
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CELEBREX, CELECOXIB, MELOXICAM, MOBIC |
1020 KB |
PDF File
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Eff. Date: 10/19/2020
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KALYDECO, ORKAMBI, SYMDEKO, TRIKAFTA |
2 MB |
PDF File
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Eff. Date: 10/26/2020
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ACTEMRA, CIMZIA, COSENTYX, ENBREL, HUMIRA, ILARIS, ILUMYA, KEVZARA, KINERET, OLUMIANT, ORENCIA, OTEZLA, RINVOQ, SILIQ, SIMPONI, SKYRIZI, STELARA, TALTZ, TREMFYA, XELJANZ |
3 MB |
PDF File
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Eff. Date: 5/10/2019
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DDAVP, DESMOPRESSIN ACETATE |
561 KB |
PDF File
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Eff. Date: 12/30/2019
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ALA-HIST DM LIQ, AP-HIST DM LIQ, ALLFEN DM TAB, BROMFED DM CGH, BROMPHENIR-PSEUDO-DM SYR, BROTAPP DM LIQ, CHILD DELSYM, CHILD C&C DM ELIX, CHILD MUCINEX, DECONEX DMX TAB, DELSYM 30MG/5ML SUSP, DELSYM CGH+CHEST CNGST DM LQ, DEXTROMETHORPHAN ER 30MG/5ML, DIMAPHEN DM ELIX, ED-A-HIST DM LIQ, ED-A-HIST DM TAB, ENDACOF-DM LIQ, EXT ACTION CGH SYR, GUIAFEN-DM ER 1,200-60MG TAB, HISTEX-DM SYR, IOPHEN DM-NR LIQ, KIDKARE C&C LIQ, LOHIST-DM SYR, LORTUSS DM LIQ, M-END DMX LIQ, M-HIST DM, MAXIPHEN DM TAB, MUCINEX CGH MINI-MELT PACK, MUCINEX DM ER 600-30MG TAB, MUCINEX DM ER 1,200-60MG TAB, MUCINEX FAST-MAX CONG-CGH, MUCINEX FAST-MAX DM MAX LIQ, NOHIST-DM LIQ, PED C&C LIQ, POLY-HIST DM LIQ, POLY-VENT DM TAB, POLYTUSSUN DM, PROMETH-DM SYR, Q-TUSS DM SYR, RESCON-DM LIQ, ROBAFEN CF LIQ, ROBAFEN-DM, ROBAFEN CGH 15MG LIQGEL, ROBAFEN DM CGH-CHEST CONG SYR, RYNEX DM LIQ, SILTUSS DM CGH SYR, SILTUSS DM DAS LIQ, SM TUSS DM, TUSS DM, VANACOF DM LIQ, VANATAB DM CAP, VIRDEC DM DRP |
220 KB |
PDF File
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08/20/2020
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DIACOMIT |
585 KB |
PDF File
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Eff. Date: 3/27/2019
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DICLOFENAC GEL 3%, DICLOFENAC SOL 1.5%, PENNSAID SOL 2% |
300 KB |
PDF File
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Eff. Date: 10/29/2019
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BONJESTA ER, DICLEGIS DR |
254 KB |
PDF File
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Eff. Date: 3/27/2019
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ALOGLIPTIN, ALOGLIPTIN-METFORMIN, ALOGLIPTIN-PIOGLIT, GLYXAMBI, JANUMET, JANUMET XR, JANUVIA , JENTADUETO, JENTADUETO XR , KAZANO, KOMBIGLYZE XR , NESINA, ONGLYZA , OSENI , QTERN , STEGLUJAN, TRADJENTA |
314 KB |
PDF File
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Eff. Date: 11/22/2019
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ALTACE, DIOVAN, RAMIPRIL |
283 KB |
PDF File
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Eff. Date: 7/17/2020
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DUPIXENT |
379 KB |
PDF File
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Eff. Date: 7/03/2019
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EMFLAZA |
306 KB |
PDF File
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Eff. Date: 09/11/2019
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ALDURAZYME, ADAGEN, CEPROTIN, ELAPRASE, FABRAZYME, LUMIZYME, NAGLAZYME, NITYR, ORFADIN, RECOVI, VIMIZIM |
366 KB |
PDF File
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Eff. Date: 08/20/2020
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EPIDIOLEX |
597 KB |
PDF File
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Eff. Date: 10/07/2020
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ARANESP, EPOGEN, PROCRIT, RETACRIT |
1 MB |
PDF File
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Eff. Date: 3/28/2019
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ABSTRAL, ACTIQ, DURAGESIC, FENTANYL, FENTORA, LAZANDA, SUBSYS |
2 MB |
PDF File
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Eff. Date: 5/10/2019
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AMRIX, CYCLOBENZAPRINE, FEXMID |
475 KB |
PDF File
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Eff. Date: 7/30/2019
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AMITIZA, LINZESS, ALOSETRON HCL, LOTRONEX, MOVANTIK, MOTEGRITY, RELISTOR, SYMPROIC, TRULANCE, VIBERZI |
777 KB |
PDF File
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Eff. Date: 7/15/2020
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ADLYXIN, BYDUREON, BYETTA, OZEMPIC, RYBELSUS, SOLIQUA, TRULICITY, VICTOZA, XULTOPHY |
354 KB |
PDF File
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Eff. Date: 02/20/2020
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GENOTROPIN, HUMATROPE, NORDITROPIN, NORDIFLEX, NORDITROPIN FLEXPRO, NUTROPIN AQ, OMNITROPE, SAIZEN, TEV-TROPIN, SEROSTIM, ZORBTIVE |
882 KB |
PDF File
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Eff. Date: 03/2018
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EPCLUSA, DAKLINZA, HARVONI, MAVYRET, OLYSIO, SOVALDI, TECHNIVIE, VIEKIRA PAK, VIEKIRA XR, VOSEVI, ZEPATIER |
77 KB |
PDF File
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Eff. Date: 03/2018
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EPCLUSA, DAKLINZA, HARVONI, MAVYRET, OLYSIO, SOVALDI, TECHNIVIE, VIEKIRA PAK, VIEKIRA XR, VOSEVI, ZEPATIER |
102 KB |
PDF File
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Eff. Date: 07/15/2019
|
BERINERT, CINRYZE, FIRAZYR, HAEGARDA, KALBITOR, RUCONEST, TAKHZYRO |
208 KB |
PDF File
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Eff. Date: 7/24/2020
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HP ACTHAR GEL |
405 KB |
PDF File
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Eff. Date: 3/29/2019
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ALDARA, IMIQUIMOD, ZYCLARA |
219 KB |
PDF File
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Eff. Date: 3/29/2019
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INCRELEX |
569 KB |
PDF File
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Eff. Date: 02/13/2020
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BETHKIS, CAYSTON, KITABIS PAK , TOBI, TOBRAMYCIN |
260 KB |
PDF File
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Eff. Date: 03/29/2019
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KETOROLAC |
382 KB |
PDF File
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Eff. Date: 3/29/2019
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KEVEYIS |
275 KB |
PDF File
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Eff. Date: 7/15/2019
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LIDOCAINE, LIDODERM, ZTLIDO |
260 KB |
PDF File
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Eff. Date:: 3/29/2019
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LOVAZA, VASCEPA |
267 KB |
PDF File
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Eff. Date: 10/28/2020
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MAKENA |
45 KB |
PDF File
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Eff. Date: 10/28/2020
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MAKENA |
47 KB |
PDF File
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Eff. Date: 5/26/2020
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FASENRA, NUCALA |
426 KB |
PDF File
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Eff. Date: 3/29/2019
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GABAPENTIN, GRALISE, HORIZANT, NEURONTIN |
673 KB |
PDF File
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Eff. Date: 3/29/2019
|
NUPLAZID |
419 KB |
PDF File
|
07/20/2020
|
APAP-CAFF-DIHYDROCOD, APAP-COD, ACTIQ, APADAZ, ASCOMP/COD, BELBUCA, BELLADONNA-OPIUM, BUPRENORPHINE, BUTALB-APAP-CAFF-COD, BUTALB-CAFF-APAP-COD, BUTALBITAL COMP-COD, BUTORPHANOL, BUTRANS, CARISOPRODOL CPD-COD, COD-GUAIFEN, COD SULFATE, DEMEROL, DILAUDID, DOLOPHINE HCL, DURAGESIC, DVORAH, EMBEDA ER, ENDOCET, FENTANYL, FENTORA, FIORINAL-COD, GUAIFEN-COD , GUAIATUSSIN AC, HYDROCODON-APAP, HYDROCODONE BT-IBU, HYDROCODONE-CHLORPHEN ER, HYDROCOD-HOMATROPINE, HYDROCODONE BT-IBU, HYDROCODONE-IBU , HYDROMET, HYDROMORPHONE, HYDROMORPHONE HCL ER, HYSINGLA ER, KADIAN ER, LAZANDA NASAL SPRAY, LEVORPHANOL, LORCET, MEPERIDINE, METHADONE, METHADOSE, MORPHABOND ER, MORPHINE, MS CONTIN, NALBUPHINE, NALOCET, NINJACOF-XG, NORCO, NUCYNTA, NUCYNTA ER, OPIUM, OXYCODONE, OXYCODONE-APAP, OXYCODONE-ASA , OXYCODONE-IBU, OXYCONTIN, OXYMORPHONE HCL, OXYMORPHONE HCL ER, PENTAZOCINE-NALOXONE, PERCOCET, PROMETHAZINE-COD, ROXICODONE, SUBSYS SPRAY, TRAMADO, TYLENOL COD, ULTRACET, ULTRAM, VICODIN, VIRTUSSIN, XTAMPZA ER |
1005 KB |
PDF File
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Eff. Date: 5/26/2020
|
CEQUA, RESTASIS MULTIDOSE, RESTASIS EYE EMULSION, XIIDRA |
267 KB |
PDF File
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Eff. Date: 10/28/2020
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ORIAHNN |
884 KB |
PDF File
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Eff. Date: 3/29/2019
|
ORILISSA |
403 KB |
PDF File
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07/24/2020
|
OXERVATE |
270 KB |
PDF File
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Eff. Date: 3/29/2019
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OXYCONTIN, OXYCODONE HCL ER, XTAMPZA ER |
2 MB |
PDF File
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08/24/2020
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PALFORZIA |
687 KB |
PDF File
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Eff. Date: 04/06/2020
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PRALUENT, REPATHA |
543 KB |
PDF File
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Eff. Date: 11/08/2019
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ADCIRCA, REVATIO, SILDENAFIL, TADALAFIL |
354 KB |
PDF File
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Eff. Date: 3/29/2019
|
PHENADOZ, PHENERGAN, PROMETHAZINE, PROMETHAZINE-CODEINE SYRUP, PROMETHEGAN |
207 KB |
PDF File
|
Eff. Date:01/30/2020
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AURYXIA, CALCIUM ACETATE, ELIPHOS, FOSRENOL, LANTHANUM CARB, PHOSLYRA SOL, VELPHORO |
231 KB |
PDF File
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Eff. Date: 3/29/2019
|
PROPYLTHIOURACIL |
399 KB |
PDF File
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Eff. Date: 3/29/2019
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RANEXA |
374 KB |
PDF File
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Eff. Date: 3/29/2019
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SAVELLA |
669 KB |
PDF File
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Eff. Date: 5/01/2019
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FARXIGA, INVOKAMET, INVOKAMET XR, INVOKANA, JARDIANCE, SEGLUROMET, STEGLATRO, SYNJARDY, SYNJARDY XR, XIGDUO XR |
265 KB |
PDF File
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Eff. Date: 01/30/2020
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OXBRYTA |
385 KB |
PDF File
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Eff. Date: 3/29/2019
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SYMLIN, SYMLINPEN |
250 KB |
PDF File
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Eff. 08/11/2020
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SYNAGIS 50 MG/0.5 ML VIAL, SYNAGIS 100 MG/1 ML VIAL |
774 KB |
PDF File
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Eff. Date: 3/29/2019
|
ACTOPLUS MET, ACTOPLUS MET XR, ACTOS, DUETACT, AVANDAMET, AVANDARYL, AVANDIA |
343 KB |
PDF File
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Eff. Date: 5/10/2019
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BENZACLIN GEL, CLINDAMY/BEN GEL, ERY/BENZOYL GEL |
482 KB |
PDF File
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Eff. Date: 8/13/2020
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ELIDEL, PROTOPIC, TACROLIMUS, EUCRISA |
863 KB |
PDF File
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Eff. Date: 12/01/2020
|
ADAPALENE, ADAPALENE-BENZYL PEROX, AKIEF, ALTRENO LOTION, ATRALIN, AVITA, CLINDA-TRETINOIN, DIFFERIN, EPIDUO, EPIDUO FORTE, FABIOR, TAZAROTENE, TAZORAC, TRETINOIN, TRETINOIN GEL MICRO, ZIANA GEL |
352 KB |
PDF File
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Eff. Date: 04/24/2020
|
TEGSEDI, VYNDAMAX, VYNDAQEL |
288 KB |
PDF File
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Eff. Date: 07/06/2012
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TYVASO |
21 KB |
PDF File
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Eff. Date: 4/26/2019
|
BUPHENYL, CARBAGLU, RAVICTI, SODIUM PHENYLBUTYRATE |
169 KB |
PDF File
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Eff. Date: 06/24/2020
|
AUSTEDO, INGREZZA, XENAZINE |
533 KB |
PDF File
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Eff. Date: 10/28/2020
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WAKIX |
660 KB |
PDF File
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Eff. Date: 09/21/2018
|
XENICAL |
44 KB |
PDF File
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Eff. Date: 3/29/2019
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XIFAXAN |
288 KB |
PDF File
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Eff. Date: 10/28/2020
|
XYREM, XYWAV |
657 KB |
PDF File
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Eff. Date: 3/29/2019
|
ZELBORAF |
290 KB |
PDF File
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Eff. Date: 08/28/2019
|
ZYFLO |
483 KB |